Managing cervical cancer in Nepal: Need of consensual guideline

1970 ◽  
Vol 4 (1) ◽  
pp. 3-10
Author(s):  
Gehanath Baral
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
Nominal Data ◽  
Intervention Level ◽  
Feasible Alternative ◽  
Early Cervical Cancer ◽  
June July

The purpose of this review is to bridge the pattern of intervention in optimal and sub-optimal facility level.Several guidelines for the screening and treatment of cervical cancer are reviewed. Routine screening isfound grossly lacking and non existent outside major health institution. Only nominal data and interventionefforts found published. There are three prongs of intervention level namely prevention/screening, treatmentand palliation together. Pap smear test is the standard screening tool wherever the cyto-diagnostic facilityexists. Visual Inspection with Acetic acid and Lugol's Iodine will be the feasible alternative at low resourcesetting. Primary surgical treatment for early cervical cancer is the best option. Likewise chemo-radiation withor without surgery will be the alternative option. Need of at least an operational guideline in each institutionis realized at this moment as a recommendation.Key words: Cervical intraepithelial neoplasia (CIN); colposcopy; Pap smear (Papanicolou stain); radicalhysterectomy; visual inspection with acetic acid (VIA).DOI: 10.3126/njog.v4i1.3324Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 3-10

scholarly journals Detection of cervical intraepithelial neoplasia (CIN) by visual inspection of cervix with acetic acid (VIA) and its comparison to cervical cytology

2019 ◽  
Vol 31 (1) ◽  
pp. 15-20
Author(s):  
Nargis Zahan ◽  
Mosammat Nargis Shamima ◽  
Sharmin Sultana ◽  
Mohd Alamgir Hossain
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Cervical Intraepithelial Neoplasia ◽  
Visual Inspection ◽  
Pap Smear ◽  
Early Stage ◽  
Invasive Cervical Cancer ◽  
Screening Method ◽  
Intraepithelial Neoplasia ◽  
Screening Tools

Background: Cervical cancer is the second most common cancer in women throughout the world, and it is the leading cause of cancer death among women in underdeveloped countries like Bangladesh is preventable and curable if detected at and early stage using proper screening tools. This study was done to see the effectiveness of VIA and find out the CIN and introduce as a complementary to cytology for diagnosing precancerous form of cervix. Materials & Methods: A total 175 subjects were studied & relevant data of cervix related patients have been collected. The data regarding Pap smear, VIA and biopsy have been taken and collected data was analysis by SPSS. Results: Out of 175 Patients VIA positive 53 (30.3%), Pap smear reports, 84 (48.0%) had inflammatory findings and 38 (21.7%) had dysplasia and biopsy result 41(23.4%) CIN positive. Sensitivity of VlA was 90.2%, specificity 88.1%, PPV 69.8%, NPV 96.7% and accuracy 88.6%. Sensitivity of Pap smear reports was 80.5%, specificity 96.3%, PPV 86.8%, NPV 94.2% and accuracy 92.6%. Conclusion: Visual inspection of cervix after application of acetic acid (VIA) is valid as cytology test for the identification of pre-invasive cervical cancer (CIN). Thus VIA is a useful screening method of Cervical Intraepithelial Neoplasia lesion as Pap smear. TAJ 2018; 31(1): 15-20

scholarly journals A study of cytology and colposcopy in VIA (visual inspection of cervix with 5% acetic acid) positive women

2018 ◽  
Vol 7 (2) ◽  
pp. 571
Author(s):  
Ruchi S. Arora ◽  
Shilpa M. Patel ◽  
Pabashi Poddar
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Diagnostic Accuracy ◽  
Visual Inspection ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Invasive Disease ◽  
Adult Women ◽  
Incidence And Mortality

Background: Cervical cancer is the most common cancer among Indian women. Cervical cancer is preventable in pre-invasive state when effective programmes are implemented to detect and treat its precursor lesions. "Single Visit" screen and treat strategy that uses VIA and colposcopy alone that eliminates the need for repeated visits due to delays in diagnostic results, will be highly attractive in terms of cost effectiveness and compliance to treatment, which is crucial to bring down the incidence and mortality due to cervical cancer. The present study evaluates the performance of colposcopy vs conventional cytology in estimating the presence and grade of cervical disease against the reference standard of histopathology as a secondary test modality to triage women found positive on primary screening by visual inspection with 5% acetic acid (VIA).Methods: This is a retrospective study carried out on 50 women aged between 18-50 years who tested positive on VIA between August 2013 to November 2015. Data were entered in the institution using standard computer software [EPIINFO software]. Diagnostic accuracy for single test was calculated using 2*2 tables and standard formulae.Results: The diagnostic accuracy of Pap smear was found to be 77% and that of Colposcopy was 87%. The accuracy of colposcopy was higher than that of Pap smear.Conclusions: Invasive cervical cancer is preceded by pre-invasive disease in most women. There is a lag time of 10-20 years before the disease progresses from pre-invasive to invasive disease. Prevention of invasive cancer is by screening, diagnosis and treatment of pre-invasive diseases. Thus, early diagnosis of CIN (cervical intraepithelial neoplasia) in adult women is a desirable goal.

scholarly journals Comparative evaluation of test characteristics of acetic acid, lugol’s iodine and toluidine blue stains in cervical cancer screening

2017 ◽  
Vol 6 (11) ◽  
pp. 4857
Author(s):  
Ankita Kumari ◽  
Neha Singh ◽  
Shaila Mitra ◽  
Reena Srivastav
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Toluidine Blue ◽  
Visual Inspection ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
Signs And Symptoms ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Lugol’S Iodine

Background: Cervical cancer rank second in female cancer and India alone account for one fourth of the global cervical cancer burden. The study was aimed to evaluate the diagnostic efficacy of acetic acid (3%), lugol’s iodine and toluidine blue (1%) in detection of abnormal cervical lesions.Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur over a period of one year from July 2016 to June 2017. The study included 200 women in age group 20-60 years with signs and symptoms suspicious of abnormal cervical lesion. The cases were subjected to detailed history, clinical examination, Pap smear, Visual inspection test, colposcopy followed by cervical biopsy.Results: Out of total 200 patients, 114 patients had acetowhite area on VIA (visual inspection with acetic acid) test, 113 were VILI (visual inspection with lugol’s iodine) positive and 107 women stained positive with Toluidine blue but only 88 showed biopsy proven pre-invasive and invasive lesions. So, sensitivity of acetic acid, lugol’s iodine and Toluidine blue was 81.8%, 84.09% and 90.9% respectively. Similarly, the specificity of the three stains were 62.5%, 65.17% and 75.8% respectively.Conclusions: Toluidine blue (1%) has proved to be significantly more sensitive and specific stain as compared to acetic acid (3%) and lugol’s iodine (50% dilution) in diagnosing pre-invasive and invasive cervical cancer. Hence, it may aid as an important tool in screening and treating precancerous and cancerous lesions.

scholarly journals Comparing the results of Pap smear and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening

2015 ◽  
Vol 56 (1) ◽  
pp. 35 ◽  
Author(s):  
Jamileh Malakouti ◽  
Shakiba Pourasad-Shahrak ◽  
Hanieh Salehi-Pourmehr ◽  
Parvin Mostafa-Garebaghi ◽  
Mohammad Asghari-Jafarabadi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Visual Inspection ◽  
Pap Smear
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